{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T22:20:09Z","timestamp":1775946009621,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Abbott Rapid Diagnostics Group"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Rotavirus group A (RVA) is a major cause of pediatric acute gastroenteritis (AGE). Vaccination is an effective public health strategy and Angola implemented it in 2014. This hospital-based study aimed to estimate the prevalence of RVA infection and the severity of AGE in children under five years of age treated at six hospitals in Luanda Province. Between April 2021 and May 2022, 1251 fecal samples were screened by an immunochromatographic rapid test (SD Bioline). Data on socio-demographic profile, nutritional status, and clinical assessment were obtained. The association of RVA infection and AGE severity with possible risk factors was evaluated with a binary logistic regression model. Overall, the detection rate was 57.8% and girls tend to be more often infected than boys (55.2%). Infection was more common in the youngest group (1 to 6 months, 60.3%). Important sources of RVA infection were drinking water kept in tanks (57.9%) and private sanitary facilities with piped water (61%). Surprisingly, according to the Vesikari Scale score, the most severe symptoms were observed in children vaccinated with two doses (80.7%). RVA prevalence remains high despite vaccination, and further studies should address the association between infection sources and disease severity, as well as the causes underlying vaccine (un)effectiveness.<\/jats:p>","DOI":"10.3390\/v16121949","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T04:07:40Z","timestamp":1734667660000},"page":"1949","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High Detection Rate of Rotavirus Infection Among Children Admitted with Acute Gastroenteritis to Six Public Hospitals in Luanda Province After the Introduction of Rotarix\u00ae Vaccine: A Cross-Sectional Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Dikudila","family":"Vita","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Agostinho Neto University, Luanda P.O. Box 116, Angola"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6186-4070","authenticated-orcid":false,"given":"Manuel","family":"Lemos","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Agostinho Neto University, Luanda P.O. Box 116, Angola"}]},{"given":"Zoraima","family":"Neto","sequence":"additional","affiliation":[{"name":"National Institute for Health Research, Luanda P.O. Box 3635, Angola"}]},{"given":"Mathebula","family":"Evans","sequence":"additional","affiliation":[{"name":"School of Health Systems and Public Health, Faculty of Health Science, University of Pretoria, Pretoria 0084, South Africa"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3255-8968","authenticated-orcid":false,"given":"Ngiambudulu M.","family":"Francisco","sequence":"additional","affiliation":[{"name":"National Institute for Health Research, Luanda P.O. Box 3635, Angola"}]},{"given":"Filomeno","family":"Fortes","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University (UNL), 1349-008 Lisbon, Portugal"}]},{"given":"Ema","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Agostinho Neto University, Luanda P.O. Box 116, Angola"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4745-3819","authenticated-orcid":false,"given":"Celso","family":"Cunha","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University (UNL), 1349-008 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4706-7598","authenticated-orcid":false,"given":"Claudia","family":"Istrate","sequence":"additional","affiliation":[{"name":"Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Interdisciplinary Center for Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/S2352-4642(21)00311-4","article-title":"Global, regional, and national causes of under-5 mortality in 2000-19: An updated systematic analysis with implications for the sustainable development goals","volume":"6","author":"Perin","year":"2022","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1007\/s13337-020-00614-x","article-title":"Prevalence and associated factors to rotavirus infection in children less than 5 years in enugu state, nigeria","volume":"31","author":"Ojobor","year":"2020","journal-title":"Virusdisease"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e03690","DOI":"10.1016\/j.heliyon.2020.e03690","article-title":"Childhood diarrhoeal diseases in developing countries","volume":"6","author":"Ugboko","year":"2020","journal-title":"Heliyon"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1001\/jamapediatrics.2018.1960","article-title":"Rotavirus vaccination and the global burden of rotavirus diarrhea among children younger than 5 years","volume":"172","author":"Troeger","year":"2018","journal-title":"JAMA Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Varghese, T., Kang, G., and Steele, A.D. (2022). Understanding rotavirus vaccine efficacy and effectiveness in countries with high child mortality. Vaccines, 10.","DOI":"10.3390\/vaccines10030346"},{"key":"ref_6","unstructured":"Angola, I.N.d.E. (2024, October 29). Resultados Definitivos Recenseamento Geral da Popula\u00e7\u00e3o e Habita\u00e7\u00e3o-2014, Available online: https:\/\/www.ine.gov.ao\/Arquivos\/arquivosCarregados\/Carregados\/Publicacao_637981512172633350.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S1473-3099(18)30362-1","article-title":"Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: A systematic analysis for the global burden of disease study 2016","volume":"18","author":"Collaborators","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21149\/9943","article-title":"The control of diarrhea, the case of a rotavirus vaccine","volume":"62","author":"Parashar","year":"2020","journal-title":"Salud Publica Mex."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"17083","DOI":"10.1038\/nrdp.2017.83","article-title":"Rotavirus infection","volume":"3","author":"Crawford","year":"2017","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Hagbom, M., Istrate, C., Engblom, D., Karlsson, T., Rodriguez-Diaz, J., Buesa, J., Taylor, J.A., Loitto, V.-M., Magnusson, K.-E., and Ahlman, H. (2011). Rotavirus stimulates release of serotonin (5-ht) from human enterochromaffin cells and activates brain structures involved in nausea and vomiting. PLoS Pathog., 7.","DOI":"10.1371\/journal.ppat.1002115"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1093\/cid\/cix369","article-title":"Effectiveness of rotavirus vaccination: A systematic review of the first decade of global postlicensure data, 2006\u20132016","volume":"65","author":"Jonesteller","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa052434","article-title":"Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis","volume":"354","author":"Velazquez","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1056\/NEJMoa052664","article-title":"Safety and efficacy of a pentavalent human-bovine (wc3) reassortant rotavirus vaccine","volume":"354","author":"Vesikari","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_14","first-page":"CD008521","article-title":"Vaccines for preventing rotavirus diarrhoea: Vaccines in use","volume":"3","author":"Bergman","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_15","unstructured":"(2024, October 29). Rotavirus Vaccine Hub. Available online: https:\/\/view-hub.Org\/vaccine\/rota?Set=current-vaccine-intro-status&group=vaccine-introduction&category=rv."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e1195","DOI":"10.1016\/S2214-109X(20)30262-X","article-title":"Real-world effectiveness of rotavirus vaccines, 2006\u20132019: A literature review and meta-analysis","volume":"8","author":"Burnett","year":"2020","journal-title":"Lancet Glob. Health"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Sadiq, A., and Khan, J. (2023). Rotavirus in developing countries: Molecular diversity, epidemiological insights, and strategies for effective vaccination. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1297269"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1002\/jmv.24510","article-title":"Molecular epidemiology of rotavirus in four provinces of angola before vaccine introduction","volume":"88","author":"Esteves","year":"2016","journal-title":"J. Med. Virol."},{"key":"ref_19","unstructured":"UNICEF (2024, October 29). Diarrhoea Remains a Leading Killer of Young Children, Despite the Availability of a Simple Treatment Solution. Available online: https:\/\/data.unicef.org\/topic\/child-health\/diarrhoeal-disease\/."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Mwene-Batu, P., Bisimwa, G., Ngaboyeka, G., Dramaix, M., Macq, J., Lemogoum, D., and Donnen, P. (2020). Follow-up of a historic cohort of children treated for severe acute malnutrition between 1988 and 2007 in eastern democratic republic of congo. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0229675"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"A159","DOI":"10.1016\/j.vaccine.2011.07.126","article-title":"Comparison of two clinical severity scoring systems in two multi-center, developing country rotavirus vaccine trials in Africa and Asia","volume":"30","author":"Lewis","year":"2012","journal-title":"Vaccine"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Gasparinho, C., Piedade, J., Mirante, M.C., Mendes, C., Mayer, C., Vaz Nery, S., Brito, M., and Istrate, C. (2017). Characterization of rotavirus infection in children with acute gastroenteritis in bengo province, northwestern angola, prior to vaccine introduction. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0176046"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1097\/INF.0000000000000957","article-title":"Etiology of diarrhea in children younger than 5 years attending the bengo general hospital in angola","volume":"35","author":"Gasparinho","year":"2016","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e134","DOI":"10.1097\/INF.0b013e31827d3b68","article-title":"Global seasonality of rotavirus disease","volume":"32","author":"Patel","year":"2013","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1080\/21645515.2016.1179412","article-title":"Incidence of rotavirus gastroenteritis by age in african, asian and european children: Relevance for timing of rotavirus vaccination","volume":"12","author":"Steele","year":"2016","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/s00705-024-05975-y","article-title":"Correlates of immune protection against human rotaviruses: Natural infection and vaccination","volume":"169","author":"Latifi","year":"2024","journal-title":"Arch. Virol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Koyuncu, A., Simuyandi, M., Bosomprah, S., and Chilengi, R. (2020). Nutritional status, environmental enteric dysfunction, and prevalence of rotavirus diarrhoea among children in zambia. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0240258"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1097\/INF.0000000000003206","article-title":"Rotavirus infection, illness, and vaccine performance in malnourished children: A review of the literature","volume":"40","author":"Burnett","year":"2021","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Chissaque, A., Cassocera, M., Gasparinho, C., Langa, J.S., Bauhofer, A.F.L., Chilaule, J.J., Joao, E.D., Munlela, B.A., Sambo, J.A.M., and Boene, S.S. (2021). Rotavirus a infection in children under five years old with a double health problem: Undernutrition and diarrhoea\u2014A cross-sectional study in four provinces of mozambique. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-020-05718-9"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.pcl.2012.10.002","article-title":"Human milk composition: Nutrients and bioactive factors","volume":"60","author":"Ballard","year":"2013","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"7288","DOI":"10.1038\/s41467-021-27074-1","article-title":"Impact of maternal antibodies and microbiota development on the immunogenicity of oral rotavirus vaccine in african, indian, and european infants","volume":"12","author":"Parker","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s41182-023-00525-9","article-title":"Impact of access to improved water and sanitation on diarrhea reduction among rural under-five children in low and middle-income countries: A propensity score matched analysis","volume":"51","author":"Merid","year":"2023","journal-title":"Trop. Med. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"214","DOI":"10.4269\/ajtmh.12-0256","article-title":"Quality of piped and stored water in households with children under five years of age enrolled in the mali site of the global enteric multi-center study (gems)","volume":"89","author":"Baker","year":"2013","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e245","DOI":"10.1017\/S0950268820002320","article-title":"Norovirus and rotavirus in children hospitalised with diarrhoea after rotavirus vaccine introduction in burkina faso","volume":"148","author":"Bonkoungou","year":"2020","journal-title":"Epidemiol. Infect."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Muendo, C., Laving, A., Kumar, R., Osano, B., Egondi, T., and Njuguna, P. (2018). Prevalence of rotavirus infection among children with acute diarrhoea after rotavirus vaccine introduction in kenya, a hospital cross-sectional study. BMC Pediatr., 18.","DOI":"10.1186\/s12887-018-1291-8"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Omotade, T.I., Babalola, T.E., Anyabolu, C.H., and Japhet, M.O. (2023). Rotavirus and bacterial diarrhoea among children in ile-ife, nigeria: Burden, risk factors and seasonality. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0291123"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1017\/S0950268818000304","article-title":"Seasonality and within-subject clustering of rotavirus infections in an eight-site birth cohort study","volume":"146","author":"Colston","year":"2018","journal-title":"Epidemiol. Infect."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1097\/INF.0000000000000048","article-title":"Hospital-based surveillance for rotavirus gastroenteritis in children younger than 5 years of age in ethiopia: 2007\u20132012","volume":"33","author":"Abebe","year":"2014","journal-title":"Pediatr. Infect. Dis. J."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/12\/1949\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:56:00Z","timestamp":1760115360000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/12\/1949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,20]]},"references-count":38,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["v16121949"],"URL":"https:\/\/doi.org\/10.3390\/v16121949","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,20]]}}}